https://www.selleckchem.com/products/dt-061-smap.html The study's conceptual framework utilized the strategies and actions underpinning the Ottawa Charter for Health Promotion. Findings of this study revealed that Bhutanese women were missing some essential health promotion services, such as antenatal education sessions mainly due to language and cultural barriers. This study recommends to develop health promotion resources in the Nepali language; and to deliver the health promotion sessions by culturally and linguistically competent providers. This study also uncovered resiliency and strengths of Bhutanese women that could be recognized, strengthened and utilized in promoting their health and well-being. © The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email journals.permissions@oup.com.OBJECTIVES Timing of pulmonary valve replacement (PVR) remains one of the most heavily debated topics in congenital cardiac surgery. We aimed to analyse the temporal evolution of QRS duration before and after PVR. METHODS We included 158 consecutive patients who underwent PVR after previous correction with transannular patch. All 3549 available serial standard 12-lead surface QRS measurements of 158 (100%) patients were analysed with linear mixed-effect modelling. RESULTS PVR was performed at a mean age of 28.0 ± 10.7 years, 23.4 ± 8.4 years after correction. Hospital survival was 98.1%. A longer time interval between ToF correction and PVR (P  less then  0.001), and an older age at correction (P = 0.015) were predictive of progressive QRS prolongation after PVR. Women on average had a shorter QRS duration (P = 0.005) after PVR. The model predicted that in patients corrected early (model age 0.5 years), PVR within 17 years after correction leads to narrowing or stabilization of QRS width. PVR beyond 17 years was associated with prolongation of QRS duration. In a patient corrected late (model age 5 years), PVR has to be performe